This competing renewal application for the Midcareer Investigator Award in Patient Oriented Research (K24) Patient-Oriented Research in Clinical Nutrition seeks support for an accomplished physician nutrition specialist and established investigator in clinical and translational nutrition science. The P.I. remains highly committed to performing patient-oriented research (POR), focused on nutrition, and in mentoring undergraduates, graduate and medical students, postdoctoral fellows, clinical residents, and junior faculty in clinical nutrition research to continue to develop a needed new cadre of well-trained investigators in Clinical Nutrition. Renewal of this proposal will provide protected time t enable the P.I. to continue to advance his research and mentoring efforts in nutrition-oriented research, and provide additional training and resources in state-of-the-art metabolomics methods that will in turn enhance his ability to mentor physicians and other clinical investigators in nutrition-related studies. The applicant has a unique training background in nutrition and medicine and an excellent record of federal, foundation and industry funding for his investigator-initiated POR and translational research. He maintains a strong and growing publication record, renewed independent funding for POR from NIH and other sources, a continued history of leadership roles in national nutrition- related societies, and increasing service on the editorial boards of front-line nutrition-oriented research journals. At Emory, the P.I. serves in the leadership of the NIH-funded CTSA grant, the Atlanta Clinical and Translational Science Institute (ACTSI), including as Co-Program Director of the ACTSI Research Education, Training and Career Development (RETCD) program, Co-Program Director of the ACTSI/RETCD KL2 postdoctoral training grant, and Program Director of the ACTSI/RETCD TL1 predoctoral training grant (TL1 RR025010). He serves in leadership roles with the Center for Clinical and Molecular Nutrition, several T32 training grants and the Emory graduate program in Nutrition and Health Science - all of which provide opportunities for continued mentoring in POR. Since the initial funding of this K24 grant (07/01/07), the P.I. has mentored the clinical/translational research activities of 32 trainees, from the level of undergraduate student to junior faculty, including a current cadre of 3 physician junior faculty members from the Emory Departments of Medicine and Pediatrics, respectively; 2 Ph.D. junior faculty investigators; 4 international physician investigators from the former Soviet Republic of Georgia; 3 physician postdoctoral fellows; 4 Ph.D.-trained postdoctoral fellows; a Pharm.D. specialist in clinical nutrition support; 3 Emory Ph.D. graduate students (2 in Nutrition and Health Sciences and 1 in Nursing) and an Emory undergraduate student. The candidate's POR program provides a rich training substrate for current and potential mentees and includes ACTSI-leveraged studies on the efficacy and metabolic impact of glutamine in catabolic states, including critical care, short bowel syndrome, cystic fibrosis. sickle cell anemia, diet-related redox control and metabolomics analysis.